A client in an urgent care clinic is complaining of heart palpitations, fatigue, and shortness of breath. A 12-lead electrocardiogram (ECG) shows no discernable P-waves, and an irregular ventricular rate. The nurse should understand that this finding represents which of the following conditions?
Atrial flutter
Atrial fibrillation
Unstable angina
Premature atrial contractions (PACS)
The Correct Answer is B
A. Atrial flutter typically presents with a regular atrial rate (usually around 250-350 beats per minute) and a characteristic "sawtooth" pattern of flutter waves (F-waves) on the ECG. This condition would not present with irregular ventricular rates and is less likely based on the ECG findings described.
B. Atrial fibrillation is identified by an irregularly irregular rhythm and the absence of P-waves on the ECG, which is replaced by erratic activity.
C. Unstable angina presents with chest pain or discomfort due to reduced blood flow to the heart muscles, usually related to atherosclerotic plaque rupture or erosion. It does not cause the ECG findings described (absence of P-waves and irregular ventricular rate).
D. PACs are early atrial depolarizations that can cause palpitations but do not typically result in the absence of P-waves or irregular ventricular rates as described in the scenario.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Whole milk contains saturated fats, which can contribute to overall cardiovascular health risks. However, it's not directly linked to causing PACs. While reducing saturated fat intake is generally beneficial for heart health, whole milk alone might not significantly exacerbate PACs compared to other dietary factors.
B. Black tea contains caffeine, which is a stimulant that can potentially increase heart rate and trigger PACs or other irregular heart rhythms in sensitive individuals. Therefore, black tea is a consideration for clients with PACs as it can be a potential trigger.
C. Bacon is high in saturated fat and sodium, which can contribute to cardiovascular risks and overall heart health concerns. High-fat foods like bacon can indirectly influence heart rhythms, but there's not a direct correlation between consuming bacon and PACs.
D. Eggs and cheese are high in saturated fats and cholesterol, which can impact cardiovascular health. While not directly linked to causing PACs, the high-fat content of scrambled eggs with cheese may contribute to overall heart health concerns.
Correct Answer is D
Explanation
A. Heparin is an anticoagulant medication used primarily to prevent and treat blood clots. It does not directly affect cardiac output or ejection fraction.
B. Adenosine is used to treat supraventricular tachycardia (SVT) by slowing conduction through the AV node. It does not directly affect cardiac output or ejection fraction in the context of heart failure.
C. Warfarin is an anticoagulant used to prevent blood clots. Similar to heparin, it does not affect cardiac output or ejection fraction.
D. Digoxin is a medication that increases the strength and efficiency of heart contractions (positive inotropic effect) and slows the heart rate (negative chronotropic effect). It is commonly used in heart failure to improve symptoms and increase cardiac output by enhancing the heart's ability to pump blood effectively.
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